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Epidemiological Study (case-control study)

Brain tumour risk in relation to mobile telephone use: results of the INTERPHONE international case-control study. epidemiol.

By: INTERPHONE Study Group, Cardis E, Deltour I, Vrijheid M, Combalot E, Moissonnier M, Tardy H, Armstrong B, Giles G, Brown J, Siemiatycki J, Parent ME, Nadon L, Krewski D, McBride ML, Johansen C, Collatz Christensen H, Auvinen A, Kurttio P, Lahkola A, Salminen T, Hours M, Bernard M, Montestruq L, Schüz J, Berg-Beckhoff G, Schlehofer B, Blettner M, Sadetzki S, Chetrit A, Jarus-Hakak A, Lagorio S, Iavarone I, Takebayashi T, Yamaguchi N, Woodward A, Cook A, Pearce N, Tynes T, Blaasaas KG, Klaeboe L, Feychting M, Lönn S, Ahlbom A, McKinney PA, Hepworth SJ, Muir KR, Swerdlow AJ, Schoemaker MJ
Published in: Int J Epidemiol 2010; 39 (3): 675 - 694 (full-text | PubMed | Journal website)

Aim of study (according to author)
An international case-control study (INTERPHONE) was conducted in 13 countries to determine whether mobile phone use increases the risk of brain tumors.
Background/further details:
The INTERPHONE study was initiated as an international set of case-control studies conducted in 13 countries ( Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden and the UK) focussing on four types of tumors (glioma, meningioma, acoustic neurinoma, and parotid gland tumor) in tissues that most absorb radiofrequency energy emitted by mobile phones. In the present publication the results of the analyses of brain tumor (glioma and meningioma) risk are presented.
Sensitivity analyses were performed to detect potential sources for bias.
Regular use of a mobile phone was defined as at least once a week for at least six months.
Final report Link

Endpoint/type of risk estimation

Estimate of incidence by odds ratio (OR)

Exposure

groups of exposure:

Reference group 1:  never or nonregular use in the past ≥ 1 year 
group 2:  regular use in the past ≥ 1 year 
Reference group 3:  never regular user 
group 4:  time since start of use: 1-1.9 years  
group 5:  time since start of use: 2-4 years  
group 6:  time since start of use: 5-9 years  
group 7:  time since start of use: ≥ 10 years  
Reference group 8:  never regular user 
group 9:  cumulative call time: < 5 h 
group 10:  cumulative call time: 5-12.9 h 
group 11:  cumulative call time: 13-30.9 h 
group 12:  cumulative call time: 31-60.9 h 
group 13:  cumulative call time: 61-114.9 h 
group 14:  cumulative call time: 115-199.9 h 
group 15:  cumulative call time: 200-359.9 h 
group 16:  cumulative call time: 360-734.9 h 
group 17:  cumulative call time: 735-1639.9 h 
group 18:  cumulative call time: ≥ 1640 h 
Reference group 19:  never regular user 
group 20:  cumulative number of calls: < 150  
group 21:  cumulative number of calls: 150-349 
group 22:  cumulative number of calls: 350-749 
group 23:  cumulative number of calls: 750-1,399 
group 24:  cumulative number of calls: 1,400-2,549  
group 25:  cumulative number of calls: 2,550-4,149 
group 26:  cumulative number of calls: 4,150-6,799 
group 27:  cumulative number of calls: 6,800-12,799 
group 28:  cumulative number of calls: 12,800-26,999 
group 29:  cumulative number of calls: ≥ 27,000 
Reference group 30:  no ipsilateral mobile phone use in the past ≥ 1 year 
group 31:  ipsilateral mobile phone use in the past ≥ 1 year 
Reference group 32:  no regular user 
group 33:  ipsilateral use, time since start of use: 1-1.9 years 
group 34:  ipsilateral use, time since start of use: 2-4 years 
group 35:  ipsilateral use, time since start of use: 5-9 years 
group 36:  ipsilateral use, time since start of use: ≥ 10 years 
Reference group 37:  no regular user 
group 38:  ipsilateral use, cumulative call time: < 5 h 
group 39:  ipsilateral use, cumulative call time: 5-114.9 h 
group 40:  ipsilateral use, cumulative call time: 115-359.9 h 
group 41:  ipsilateral use, cumulative call time: 360-1639.9 h 
group 42:  ipsilateral use, cumulative call time: ≥ 1640 h 
Reference group 43:  no regular user 
group 44:  ipsilateral use, cumulative number of calls: 150 
group 45:  ipsilateral use, cumulative number of calls: 150-2,549 
group 46:  ipsilateral use, cumulative number of calls: 2,550-6,799 
group 47:  ipsilateral use, cumulative number of calls: 6,800-26,999 
group 48:  ipsilateral use, cumulative number of calls: ≥ 27,000 
Reference group 49:  no regular user 
group 50:  contralateral use, time since start of use: 1-1.9 years 
group 51:  contralateral use, time since start of use: 2-4 years 
group 52:  contralateral use, time since start of use: 5-9 years 
group 53:  contralateral use, time since start of use: ≥ 10 years 
Reference group 54:  no regular user 
group 55:  contralateral use, cumulative call time: < 5 h 
group 56:  contralateral use, cumulative call time: 5-114.9 h 
group 57:  contralateral use, cumulative call time: 115-359.9 h 
group 58:  contralateral use, cumulative call time: 360-1639.9 h 
group 59:  contralateral use, cumulative call time: ≥ 1640 h 
Reference group 60:  no regular user 
group 61:  contralateral use, cumulative number of calls: 150 
group 62:  contralateral use, cumulative number of calls: 150-2,549 
group 63:  contralateral use, cumulative number of calls: 2,550-6,799 
group 64:  contralateral use, cumulative number of calls: 6,800-26,999 
group 65:  contralateral use, cumulative number of calls: ≥ 27,000 

Population

Further parameters acquired by questionnaire (sociodemographic factors, occupational exposure to electromagnetic fields and ionizing radiation, medical history (subject's and family), medical ionizing and non-ionizing radiation exposure, smoking)

Study size i cases  controls 
number eligible 7,41614,354
number participating 5,1907658
number available for analysis 5,1175,634

Other: 2409 meningioma cases and 2708 glioma cases

Statistically significant results i

 group  exposure  endpoint  cases  controls  parameter (OR confidence interval 
2regular use in the past ≥ 1 yearglioma166618940.810.70-.094
2regular use in the past ≥ 1 yearmeningioma126214880.790.68-0.91
18cumulative call time: ≥ 1640 hmeningioma1301071.150.81-1.62
18cumulative call time: ≥ 1640 hglioma2101541.401.03-1.89

Statistical analysis using conditional logistic regression (adjusted for educational level), sensitity analysis (e.g., study center, interview quality, subjects reporting implausible high amounts of mobile phone use)

Results/conclusion (according to author)
A reduced risk related to ever having been a regular mobile phone user was observed for the brain tumors glioma (OR 0.81; CI 0.70-0.94) and meningioma (OR 0.79; CI 0.68-0.91), possibly reflecting participation bias or other methodological limitations. In the highest exposure group (cumulative call time ≥ 1640 h) an increased risk was observed for glioma (OR 1.40; CI 1.03-1.89) and for meningioma (OR 1.15; CI 0.81-1.62); but there were implausible values reported in this group (e.g., mobile phone use more than 5 h/day). The risk for glioma tended to be greater in the temporal lobe than in other lobes of the brain and greater in subjects reporting usual mobile phone use on the same side of the head as the tumor was located (ipsilateral use) than on the opposite side (contralateral use).
The authors concluded that overall no increase in risk of the brain tumor types glioma and meningioma was observed in association with use of mobile phones. There were suggestions of an increased risk of glioma and much less of meningioma at the highest exposure levels.

Limitations (according to author): Bias and error limit the strength of conclusion and prevent causal interpretation.

(Study character: epidemiological study, case-control study)

Study funded by

Published comments on this article:Related articles i
Glossary: acoustic neurinoma, analog, bias, brain, brain tumor, case-control study, CI, conditional logistic regression, contralateral, cumulative, diagnostic imaging, digital, electromagnetic fields, emitted, endpoint, epidemiological, exposure, frequency, glioma, histologically, incidence, initiated, Interphone, ionizing, ionizing radiation, ipsilateral, laterality, matching, medical history, meningioma, mobile communication, mobile phone, neurological, non-ionizing radiation, occupational exposure, OR, parotid gland tumor, population-based, potential, questionnaire, radiofrequency, risk, sensitivity, statistical, subjects, temporal lobe, tissues, tumor
Exposure: mobile communication system, analog mobile phone, digital mobile phone, personal exposure
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